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Primary Retinal Detachment

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100<br />

the operating table with the retina still detached, in contrast to<br />

the one after drainage or the injection of a gas bubble after<br />

drainage, in which case the retina is already attached at the<br />

table. Following such an operation, the surgeon can feel relaxed<br />

and, as often said,“sleep better.” However, the secrets of success<br />

with nondrainage are: first, the surgeon has to be convinced<br />

that all of the breaks have been found and tamponaded sufficiently,<br />

and, second, a spontaneous attachment on the next day<br />

will confirm that all of the breaks were found and tamponaded<br />

sufficiently. However, this will be the case only in retrospect, i.e.,<br />

hours after surgery combined with postoperative concern on<br />

the part of the surgeon. However, by performing drainage, often<br />

explained as being done for the sake of the surgeon or the patient,<br />

the retina might be attached at the table only temporarily,<br />

due to the drainage alone.<br />

As a consequence, the “conditio sine qua non” for spontaneous<br />

attachment after nondrainage is that all of the leaking breaks have<br />

been found and tamponaded sufficiently intraoperatively. Otherwise,<br />

the spontaneous or “magic” disappearance of subretinal fluid<br />

will not occur. Other questions were:<br />

3. Will a buckle that is unsupported by an encircling band persist?<br />

4. Is the prophylactic value of a cerclage needed for long-term<br />

retinal attachment?<br />

Minimal Segmental Buckling With Sponges and Balloons<br />

Without Drainage (Extraocular Minimal Surgery)<br />

Specifics<br />

6 Minimal Segmental Buckling With Sponges and Balloons<br />

This surgery is derived from the cryosurgical detachment operation<br />

of Lincoff, introduced in 1965 [16], which brought about two<br />

major changes: (1) the change from intraocular to extraocular<br />

surgery, since drainage of subretinal fluid was omitted and (2)<br />

the change from a surgery of the detachment to a surgery of the

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